@article{3057684,
    title = "SGLT2 inhibitors: A review of their antidiabetic and cardioprotective effects",
    author = "Tentolouris, A. and Vlachakis, P. and Tzeravini, E. and Eleftheriadou, I. and Tentolouris, N.",
    journal = "International Journal of Environmental Research and Public Health",
    year = "2019",
    volume = "16",
    number = "16",
    publisher = "MDPI AG",
    issn = "1660-4601",
    doi = "10.3390/ijerph16162965",
    keywords = "adipocytokine;  antilipemic agent;  antithrombocytic agent;  canagliflozin;  cytokine;  dapagliflozin;  dipeptidyl peptidase IV inhibitor;  diuretic agent;  empagliflozin;  ertugliflozin;  glimepiride;  glitazone derivative;  glucagon like peptide 1 receptor agonist;  hydroxymethylglutaryl coenzyme A reductase inhibitor;  insulin;  linagliptin;  liraglutide;  metformin;  oral antidiabetic agent;  phlorizin;  pioglitazone;  placebo;  ramipril;  simvastatin;  sitagliptin;  sodium glucose cotransporter 1;  sodium glucose cotransporter 2;  sodium glucose cotransporter 2 inhibitor;  sulfonylurea;  antidiabetic agent;  cardiotonic agent, cardiovascular disease;  diabetes;  drug;  health risk;  metabolism, acute kidney failure;  add on therapy;  antidiabetic activity;  arterial stiffness;  bladder cancer;  blood pressure;  body weight;  bone density;  breast cancer;  cardiac muscle cell;  cardiovascular disease;  cardiovascular risk;  cell metabolism;  cerebrovascular accident;  chronic kidney failure;  combination drug therapy;  cytokine production;  diabetic ketoacidosis;  diet therapy;  dizziness;  dosage schedule comparison;  drug dose regimen;  drug efficacy;  drug mechanism;  drug megadose;  drug potency;  drug safety;  drug selectivity;  drug tolerability;  dyslipidemia;  edema;  end stage renal disease;  evening dosage;  exercise;  Fournier gangrene;  fracture;  genital tract infection;  glucosuria;  glycemic control;  heart failure;  heart infarction;  heart muscle fibrosis;  heart muscle necrosis;  heart protection;  heart work;  human;  hypoglycemia;  leg amputation;  monotherapy;  morning dosage;  non insulin dependent diabetes mellitus;  orthostatic hypotension;  proton sodium exchange;  renal protection;  Review;  side effect;  urinary tract infection;  adverse event;  animal;  cardiovascular system;  drug effect;  non insulin dependent diabetes mellitus, Animals;  Cardiotonic Agents;  Cardiovascular System;  Diabetes Mellitus, Type 2;  Humans;  Hypoglycemic Agents;  Sodium-Glucose Transporter 2 Inhibitors",
    abstract = "Type 2 diabetes mellitus is a chronic metabolic disease associated with high cardiovascular (CV) risk. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are the latest class of antidiabetic medication that inhibit the absorption of glucose from the proximal tubule of the kidney and hence cause glycosuria. Four SGLT2i are currently commercially available in many countries: canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin. SGLT2i reduce glycated hemoglobin by 0.5%–1.0% and have shown favorable effects on body weight, blood pressure, lipid profile, arterial stiffness and endothelial function. More importantly, SGLT2i have demonstrated impressive cardioprotective and renoprotective effects. The main mechanisms underlying their cardioprotective effects have been attributed to improvement in cardiac cell metabolism, improvement in ventricular loading conditions, inhibition of the Na+/H+ exchange in the myocardial cells, alteration in adipokines and cytokines production, as well as reduction of cardiac cells necrosis and cardiac fibrosis. The main adverse events of SGLT2i include urinary tract and genital infections, as well as euglycemic diabetic ketoacidosis. Concerns have also been raised about the association of SGLT2i with lower limb amputations, Fournier gangrene, risk of bone fractures, female breast cancer, male bladder cancer, orthostatic hypotension, and acute kidney injury. © 2019 by the authors. Licensee MDPI, Basel, Switzerland."
}